Second-Line Antibiotics More Effective in Acute Bronchitis

But authors of new meta-analysis caution that their findings should be carefully interpreted

THURSDAY, Aug. 16 (HealthDay News) -- In patients with acute exacerbations of chronic bronchitis, second-line antibiotics may be more effective than first-line antibiotics, according to study findings published in the August issue of Chest.

George Dimopoulos, M.D., of Attikon University Hospital in Athens, Greece, and colleagues performed a meta-analysis of 12 randomized controlled trials that included 2,261 adult patients.

In clinically evaluable patients, the researchers found that first-line antibiotics were associated with lower treatment success than second-line antibiotics (odds ratio, 0.51). In microbiologically evaluable patients, however, they found no significant differences between regimens in mortality, treatment success, or the frequency of adverse effects such as diarrhea.

"This finding provides further support to the suggestion by some experts that advanced antibiotics are preferable to the old antibiotics for this purpose when the administration of antimicrobial agents is recommended," the authors write. "[But] the observed clinical advantage of the second-line antibiotics should be very carefully interpreted in light of issues related to the design of the randomized controlled trials included in this meta-analysis, concerning mainly the characteristics of the patients who were included in the randomized controlled trials."

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